Healthcare Provider Details

I. General information

NPI: 1871667683
Provider Name (Legal Business Name): MOSES TAYLOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 QUINCY AVE
SCRANTON PA
18510-1724
US

IV. Provider business mailing address

PO BOX 1369
SCRANTON PA
18501-1369
US

V. Phone/Fax

Practice location:
  • Phone: 570-340-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIAN BEPPLER
Title or Position: MANAGER
Credential:
Phone: 570-340-2987